July 18, 2011
The government does a horrible job balancing its budget. It blames its problems on every sector of the economy and fails to ever take responsibility for its own fiscal irresponsibility. Have you ever heard any politician apologize for the mess we are in? Of course not!
By far, the sector of the economy taking the most heat is mine, healthcare. Every day, in every news media is a story about the rising cost of healthcare and the government’s effort to control it. Have you ever seen a story about the cost of the government’s interventions? Again, no!
The government is data mining at everyone’s expense. I do not know of any study that shows that electronic medical records (EMR) improve “outcomes”; yet the government and their masters, the insurance companies of America, have forced electronic medical records down the throats of U.S. physician.
Why data mining and what’s the expense? Data mining is being used to collect information about the masses in order to create “protocols” which will lead to pre-specified “outcomes”. Confused? You should be because “quality” depends on where you sit. Are you a sick patient or are you a statistic in my EMR. To balance the healthcare budget without seeming to take anything away from patients, the government and insurers must redefine what “quality” healthcare is. As previously stated, the government’s definition of a good “outcome” is reducing spending. The insurer’s definition of a good “outcome” is making more profit this quarter then last quarter.
Data mining cost money! An EMR runs upwards from one hundred thousand dollars to set up and operate. Your doctor shoulders that expense. On top of that cost is the hidden cost of extra time spent clicking on data points that have nothing to do with taking care of the patient’s needs.
In the government’s lust for data, they are insatiable! Physicians are reimbursed based on diagnostic codes and procedures codes. Our current coding system is oppressive. Time is wasted everyday on coding what we have done. There are professional coders whose job is to check and verify everything. We have three in my office. Their time is costly. When they said you have to spend money to make money, I didn’t realize that meant I had to spend money to collect what is owed to me; but I do. Its part of the expense of modern medicine and it is about to get much more costly.
Our current system is called “ICD 9”. Next year, the government is going to force “ICD 10” on every medical facility and physician in this country. By their own estimates, it will cost $60,000 to train and implement “ICD 10” in my office. We all know how accurate our governments financial estimates are, don’t we? I expect “ICD 10” will cost me in excess of $100,000 dollars and cripple my office for more than a year?
If you think wait times are bad now, wait until we have to code to the umtheenth digit in order to feed our government and the insurers’ lust for information about you and me! Privacy in medicine will be a thing of the past, if it isn’t already.
So where is this money going to come from? Medicare has already posted their 2012 reimbursement schedule and expects me to function on 30% less than I receive now. The insurers will follow suit. Independent physicians won’t have the money to comply with Medicare’s and the insurers’ edicts. Bankruptcy is out of the question! That leaves one choice, sell to the hospital (ACO) or insurer and be an employed physician.
The death of the independent, private practitioner seems imminent. Medicine by protocol seems imminent. America’s perception of “quality” healthcare has been perverted by the government, insurers, and their media stooges for years. Why do foreign nationals come here for medical care? Because despite what you may read in the media, we have the best care available anywhere!
What is your medical care worth to you? What is your privacy worth to you? We are all about to find out. With EMRs recording data under “ICD 10” there will be no privacy. With employed PCPs practicing by “protocol” to obtain the prescribed “outcome”, there will be no care.
I, for one, have practiced medicine as a DOCTOR (not PCP) for over 30 years. I am too old and care too much to practice by protocol. If all the above comes to pass, I will be available to those who want individualized care and privacy on a cash basis. Oher dinosaurs like myself, are already transitioning to cash only practices. Until then, my open door policy, accepting almost all who walk in, will remain in effect.